Organization
VANGUARD MEDICAL IMAGING P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA A CORRENTE M.D. (MEDICAL DIRECTOR)
(516) 495-5200
Entity
Organization
Contact information
Practice address
520 OLD COUNTRY RD, PLAINVIEW, NY 11803-6501
(516) 495-5200
(516) 495-5201
Mailing address
8 CORPORATE CENTER DRIVE, 105, MELVILLE, NY 11747-3193
(631) 396-1050
(631) 396-0787
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
222791-1
NY
Other
Enumeration date
08/02/2012
Last updated
10/05/2012
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